Introduction: Distinct Histopathological Growth Patterns (HGPs) can be identified in liver metastases originating from melanoma, breast- and colorectal cancer. HGPs are related to survival after resection. A desmoplastic HGP, characterized by a desmoplastic ring separating the tumour cells from the liver parenchyma, marks good prognosis for each of these tumours. Whether HGPs extend to other tumour types and can be considered a pan-cancer phenomenon remains unknown. This study evaluates the presence of HGPs and their prognostic value in non-colorectal, non-neuroendocrine liver metastases. Methods: A retrospective multicentre study was performed in patients who underwent curative-intent resection of non-colorectal, non-neuroendocrine liver metastasis. HGPs were classified as desmoplastic or non-desmoplastic on H&E slides according to consensus guidelines. Overall- (OS) and recurrence free (RFS) survival were evaluated using Kaplan-Meier and multivariable Cox regression analysis. Results: In total, 132 patients with liver metastasis from 25 tumour types (95 carcinoma, 9 sarcoma, 14 melanoma, 14 other) were considered eligible for analysis, of which 26 (20%) had a desmoplastic HGP. Five-year OS and RFS (95%CI) were 53% (36-78%) versus 40% (30-53%), and 33% (19-61%) versus 15% (9-27%) for desmoplastic compared to non-desmoplastic patients, respectively (p=0.031 & p=0.004, Figure 1). On multivariable analysis (HR [95%CI]) a desmoplastic HGP was prognostic for both OS (0.46 [0.25-0.86], p=0.01) and RFS (0.38 [0.21-0.69], p<0.01) (table 1). Conclusions: This study demonstrates that HGPs extend to a variety of liver metastatic tumours and suggests that the desmoplastic HGP is a pan-cancer biomarker for good survival after surgical resection of liver-metastasis. Figure. Tabled 1Table. Uni-and Multivariable Cox regression for OS and RFSOverall SurvivalUnivariatepMV (n=124)pProgression Free SurvivalUnivariatepMV (n=119)pChemotherapyReference-Reference-ChemotherapyReference-Reference-No ChemotherapyNo ChemotherapyNeoadjuvant0.90 [0.52-1.53]0.690.98 [0.56-1.74]0.96Neoadjuvant0.71 [0.43-1.15]0.160.75 [0.45-1.25]0.26Adjuvant3.93 [0.92-16.80]0.065.49 [1.18-25.46]0.03Adjuvant1.73 [0.41-7.27]0.452.83 [0.63-12.78]0.18Neoadjuvant and adjuvant1.16 [0.63-2.14]0.631.14 [0.59-2.18]0.7Neoadjuvant and adjuvant1.17 [0.68-2.02]0.561.31 [0.73-2.35]0.37Nr. LM (multiple)1.44 [0.89-2.31]0.141.33 [0.80-2.21]0.27Nr. LM (Multiple)1.34 [0.87-2.09]0.191.25 [0.77-2.01]0.36Adam Score1.15 [0.98-1.35]0.091.21 [1.04-1.42]0.02Adam Score1.15 [0.99-1.35]0.071.27 [1.08-1.48]<0.01HGP (Non-desmoplastic)0.52 [0.28-0.95]0.030.51 [0.27-0.95]0.04HGP (Non-desmoplastic)0.44 [0.25-0.78]<0.010.38 [0.21-0.71]<0.01 Open table in a new tab